Dec. 4, 2011

Walt Zerrenner, upper left, and his wife Aline visit Dr. Thomas G. Mattio to look at Aline's third MRI as well as her neuro-psychological test results on Sept.1 at Neuroscience Group in Neenah. / Post-Crescent photo by Dan Powers

Written by

Michael Louis Vinson

Post-Crescent staff writer

COSTS

In addition to spending thousands of dollars each year on hospital visits and medication for Alzheimer’s patients, Americans also incur significant nonmedical care costs. » Home care. In 2009, nonmedical home care cost about $20 per hour or $160 for an eight-hour day.» Adult day care. In 2009, adult day care services cost an average of $69 per day.» Assisted living facilities. In 2009, basic services at an assisted living facility cost about $3,216 per month, or $38,596 per year. Specialized Alzheimer’s-related facilities charged an average of $4,556 per month, or $54,670 per year.» Nursing homes. In 2009, the average price tag for a private room in a nursing home was $225 per day, or $82,113 per year. A semi-private room cost an average of $203 per day, or $74,239 a year. Private rooms at a nursing home that specialized in Alzheimer’s-related care cost about $239 per day, or $87,362. A semi-private room at such a facility was about $214 per day, or $77,998 per year.» Medicare. In 2004, Medicare payments on healthcare and long-term care services averaged $19,304 per person (adjusted for inflation). Medicaid payments per person hit $8,419. Out-of-pocket costs were about $3,141 per patient and private insurance companies spent $2,354 for person.

FINANCIAL TIPS

The Alzheimer’s Association encourages families to start making financial plans soon after diagnosis. As the disease progresses, needs change. Costs may include hospital visits, medications, supplies, adult day care services, in-home care services and nursing home services.Here are some of the group’s financial tips:» Don’t avoid talking about finances and future care wishes.» Organize and review important financial documents, including wills and tax returns.» Get help from qualified financial and legal advisors.» Estimate the total potential cost for the entire disease process.» Review a variety of insurance options, including long-term care insurance.» Work-related salary/benefits and personal property should be considered as potential income.» Find out if you’re eligible for government assistance through programs such as Medicare and Medicaid.» Learn whether you qualify for income tax breaks.» Take advantage of low-cost and free community services.Source: Alzheimer’s Association, www.alz.org

BY THE NUMBERS

» 5.4 million: Estimated number of Americans who have Alzheimer’s disease. Given the aging population, by 2050, that number is expected to triple in the absence of new prevention methods. » 1 in 8: Ratio of people age 65 or older who have Alzheimer’s.» 43: Percentage of people age 85 or older who have Alzheimer’s.» 66: Percentage of all people with Alzheimer’s who are women.» 96: Percentage of all people with Alzheimer’s who are 65 years of age or olderSource: Alzheimer’s Association, www.alz.org

WARNING SIGNS

Alzheimer’s can affect people in different ways, but often the symptoms start with a gradually worsening ability to remember new information. Some of the warning signs:» Memory loss that disrupts daily life.» Challenges in planning or solving problems.» Difficulty completing familiar tasks at home, at work or at leisure.» Confusion with time or place.» Trouble understanding visual images and spatial relationships.» New problems with words in speaking or writing.» Misplacing things and losing the ability to retrace steps.» Decreased or poor judgment.» Withdrawal from work or social activities.» Changes in mood and personality.For more information visit www.alz.org/10signsSource: Alzheimer’s Association, www.alz.org

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APPLETON — When Appleton resident Andrew “Bud” Kangas, 77, was told in March he has Alzheimer’s disease, a family member took power of attorney over his finances and health care decisions.

“It’s been a financial problem and we’re trying to get that under control,” Bud Kangas said. “I can’t handle the finances anymore.”

Marge Kangas, 78, Bud’s wife of 56 years, is his primary caregiver at home, where he has had difficulty adjusting to the realities of Alzheimer’s, the most common form of dementia — an incurable, progressive, debilitating group of symptoms affecting intellectual and social abilities. Dementia directly affects 5.4 million Americans, the vast majority of whom are over the age of 65.

“Bud always was the boss around here, and he’s having a hard time accepting that he can’t do things the way he normally did them,” Marge Kangas said.

The Kangases are not alone. As baby boomers race past the age of 65 en masse, the number of Americans who suffer from Alzheimer’s disease is expected to nearly triple to 16 million people by 2050. In turn, total treatment and care costs could balloon sixfold to $1.1 trillion.

“It’s a huge, escalating burden on both families and our society,” said Diana Butz, a spokeswoman for the Greater Wisconsin Chapter of the Alzheimer’s Association. “It will bankrupt this country.”

Older, costlier

The government, private insurance companies and families will spend about $183 billion this year to care for Americans who have Alzheimer’s, up 6.4 percent compared with 2010 figures.

“Medicare costs for an older person with Alzheimer’s are already three times higher than the average for (other people in the same age group),” Butz explained.

And those costs will only grow as baby boomers — Americans born between 1946 and 1964 — age and older people account for a greater percentage of the U.S. population.

A report this past week from the U.S. Census Bureau showed that the population of Americans age 65 and older grew faster than the total population in the last decade, a trend that is expected to accelerate over the next half-century as the 65-and-older population doubles to 71 million by 2030.

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By 2050, Alzheimer’s-related Medicare costs are expected to rise 600 percent to $627 billion annually. Medicaid payments to low-income and disabled Americans with Alzheimer’s could grow 400 percent in that same period to $178 billion.

“A lot of the costs are really driven by the fact that most of the people with Alzheimer’s disease (spend) years in the (most) severe stage of the disease,” Butz said.

Studies show that people age 65 and older live about four to eight years after their disease has been diagnosed. Typically, Alzheimer’s patients spend about 40 percent of that time in the most severe stage, which often requires nursing home care.

In 2009, the average cost for a private nursing home room was $225 per day, or $82,000 a year, according to data from the Alzheimer’s Association.

The cost for a similar room in a nursing facility that offers specialized care for Alzheimer’s patients was $239 a day, or more than $87,000 a year.

Family finances

Before progressing to the most severe stage, many people with Alzheimer’s, like Bud Kangas, receive care from family members at home. Last year, 15 million friends and family members spent an average of 22 hours per week caring for a relative with Alzheimer’s disease.

In Wisconsin alone, nearly 200,000 friends and relatives provided an estimated $2.5 billion in unpaid care to dementia and Alzheimer’s patients in 2010.

Aline and Walt Zerrenner, who The Post-Crescent profiled earlier this fall, spend thousands of dollars each year to care for Aline’s vascular dementia and advanced Alzheimer’s disease, which was diagnosed in June.

Walt Zerrenner said his family spends about $5,000 a year on medications, $3,500 on long-term care insurance and $3,000 on doctors and dental visits. Long-term care insurance covers $19-an-hour home care costs as well.

Butz said similar costs are steadily draining family savings across the country.

“A person can lose essentially everything that he has because of the cost of caring for a loved one with Alzheimer’s disease,” Butz said.

The Alzheimer’s Association says families should put fiscal and legal plans in place as soon as possible after diagnosis to lessen the financial strain, which is what the Kangas and Zerrenner families have done.

“We encourage families to engage in some comprehensive advanced planning,” Butz said. “We’re finding that it’s not being done, and then by the time a person is at that stage, the costs are just staggering.”